What is the pulse rate?

Taking a pulse rate is checking the number of times the heart beats per
minute. When checking a pulse it also checks the heart rhythm and the
strength of the pulse. For example, the strength or weakness of the pulse
indicates overall heart-health. The normal pulse for healthy adults ranges
from 60 to 100 beats per minute.
Step 1- Relax the patient arm on the table. The patients palm should be
facing the ceiling and the fingers should be relaxing as well.
Step 2- Use the first and second fingertips, and place it on the patients
wrist or where the forearm meets the upper arm press firmly but gentle on
the arteries until one can feel a pulse. (As the picture shown below)
Step 3- Keep hand on the pulse and begin counting the pulse. Count the
second hand on whatever the number that was start from. Count pulse for
60 seconds (or for 15 seconds and multiply by four to calculate beats per
minute).
Note: When counting, concentrate on the beats. Try not to watch the
clock continuously, so it does not become confusing.
Step 4- Chart down the results when done. If one is unsure about the result
ask someone to watch the clock while one counts the beats.

What Is the Respiration?

Respiration is the number of breaths a person takes per minutes. While
counting the number of times a persons chest rises. When taking
respiration it is important that one pays close attention to the chest. A
normal respiration would be 15-20 breaths per minutes.
Note: When taking respiration do not tell the person that he or she is
being watching breathing. A person tends to breathe differently when they
are aware of someone checking their respiration.
Step 1- Tell the patient to sit up straight and relax and breathe.
Step 2- As the patient is breathing gently place hands on their upper chest
and middle back. Then look at the chest as it rises.
Steps 3- When the chest rises then begin to count to a full minute. Once
the counting is finished then record how many times the chest rises and
that will be the answer.

What is Blood Pressure?

Blood pressure is measured with a blood pressure cuff and stethoscope.
Each heart beat pumps the blood in the arteries, the highest blood pressure
as the heart contracts. If one does not have an electronic blood pressure
monitoring then they are not able to take their blood pressure without this
particular equipment.
When measuring blood pressure there are two numbers that should be
recorded, they are systolic pressure and the diastolic pressure. The systolic
pressure is the higher number of pressure inside the artery when the heart
contracts and pumps the blood throughout the body. On the other hand the
diastolic is the lower number of pressure inside the artery when the heart is
resting and is filled with blood.
Note: When measuring blood pressure rest for three to five minutes without taking a
measurement.

Step 1- Sit patient in a comfortable chair, with his or her back supported
with legs uncrossed. (No movement should be allowed).
Step 2- Place patient arm on a table or hard surface. Make sure the arm is
being relaxed and patient is comfortable.
Step 3- Wrap the cuff carefully around the patient upper part of the arm.
Note: The cuff should be sized easily for the patient, so that it would have
enough room for one fingertip to slip underneath.
Step 4- Place the stethoscope in the care giver ear. Then place the
Diaphragm underneath the cuff on the artery.
Step 5- Care giver should pump the cuff to make sure that it works. Also
turn the knob to make sure there is no air in the cuff.
Step 6-The Care giver should begin pumping the cuff until the
measurement says 180. Slowly unleash the turning knob and listen to the
heart beat.

Warning: If the cuff is pumped over the amount that is giving, it can
cause serious damage to the patient health.
Step 7- The first heart beat should be measured, and the least beat should
be measured and that will indicate the systolic pressure and diastolic
pressure.

Blood pressure
To record blood pressure, a person should be seated with one arm bent slightly, and
the arm bare or with the sleeve loosely rolled up. With an aneroid or automatic unit,
the cuff is placed level with the heart and wrapped around the upper arm, one inch
above the elbow. Following the manufacturer's guidelines, the cuff is inflated and
then deflated while an attendant records the reading.
If the blood pressure is monitored manually, a cuff is placed level with the heart and
wrapped firmly but not tightly around the arm one inch above the elbow over the
brachial artery. Wrinkles in the cuff should be smoothed out. Positioning
a stethoscope over the brachial artery in front of the elbow with one hand and
listening through the earpieces, the cuff is inflated well above normal levels (to about
200 mmHg), or until no sound is heard. Alternatively, the cuff should be inflated 10
mm Hg above the last sound heard. The valve in the pump is slowly opened. Air is
allowed to escape no faster than 5 mmHg per second to deflate the pressure in the
cuff to the point where a clicking sound is heard over the brachial artery. The reading
of the gauge at this point is recorded as the systolic pressure.
The sounds continue as the pressure in the cuff is released and the flow of blood
through the artery is no longer blocked. At this point, the noises are no longer heard.
The reading of the gauge at this point is noted as the diastolic pressure. "Lub-dub" is
the sound produced by the normal heart as it beats. Every time this sound is
detected, it means that the heart is contracting once. The noises are created when the
heart valves click to close. When one hears "lub," the atrioventricular valves are
closing. The "dub" sound is produced by the pulmonic and aortic valves.
With children, the clicking noise does not disappear but changes to a soft muffled
sound. Because sounds continue to be heard as the cuff deflates to zero, the reading
of the gauge at the point where the sounds change is recorded as the diastolic
pressure.
Blood pressure readings are recorded with the systolic pressure first, then the
diastolic pressure (e.g., 120/70).
Blood pressure should be measured using a cuff that is correctly sized for the person
being evaluated. Cuffs that are too small are likely to yield readings that can be 10 to

50 millimeters (mm) Hg too high. Hypertension (high blood pressure) may be

incorrectly diagnosed.

How to take an individuals temperature using a mercuryfree thermometer

or a glass thermometer:
Hold the thermometer by the stem
Shake the thermometer down to below the lowest number (at least below
96 degrees) before placing it under the individuals tongue.
To shake thermometer down, hold it at the end opposite the bulb with the
thumb and two fingers. With a snapping motion of the wrist shake the
thermometer. Stand away from walls and furniture to prevent accidents!
Use a plastic slip to cover thermometer (if available)
Place the thermometer under the tongue and to one side; have individual
close mouth (breathing through the nose), for at least three minutes
Remove the thermometer. Wipe with tissue from stem to bulb or remove
plastic cover
Hold thermometer at eye level by the stem (not the bulb). Rotate until the
line appears or the colored side is facing away from you. Roll the
thermometer between your thumb and forefinger, and read temperature.

Pulse
The pulse rate is the number of times the heart beats per minute.
Arteries carry blood from the heart to all parts of the body. A pulse is the beat of
the heart felt at an artery as a wave of blood passes through the artery. You can
feel a pulse every time the heart beats. You can feel a pulse most plainly over
these arteries: Radial in the wrist, usually at the base of the thumb

Carotid on each side of the neck

Apical over heart with a stethoscope
The easiest and most common place to measure the pulse is to feel the artery in
the wrist. This area is located on the inside of the wrist on the thumb side. You
will use two fingers to feel the artery. Never use the thumb because there is a
pulse in it, press just hard enough to feel the pulse, if you press too hard you may
not feel anything!

How to take an individuals respiration rate:

You may want to place your fingers on the persons wrist
Count persons respirations for 60 seconds (inhale + exhale =1 breath)
Note any irregularities
Document respiration rate and any abnormal findings or irregularities

How to take an individuals blood pressure:

Clean ear pieces and diaphragm of stethoscope with alcohol and cotton
balls. The diaphragm is the larger round side of the stethoscope.
Locate brachial pulse on the inside of the elbow. It is about one to one
and a half inches above the elbow; you should be able to feel a strong
steady pulse with two or three of your fingers.
Wrap and fasten deflated cuff smoothly and snuggly around persons
upper arm. (Place cuff at least one inch above elbow; point arrow on cuff
at brachial pulse)
Place ear pieces of stethoscope in your ears
Place diaphragm of stethoscope over the brachial pulse
Close valve on air pump (turn knob to the right to close)
Pump air to inflate cuff until the dial points to 170

 Deflate cuff slowly and at a constant rate (turn knob to the left slowly)
Watch numbers as needle falls
Listen for the first thumping sound
Note number where first thump (systolic pressure) is heard
Note number where last clear thump (diastolic pressure) is heard
Deflate cuff completely
Document and report any abnormal readings

Prohibid for Diabetes Melitus :

strenuous exercise, bananas, instant foods, caffeine, potatoes or carbohydraterich foods, fried foods, soda, alcohol

Suggestion for DM :
Avoiding stress, consume lots of peas, beans, and beans, meat poultry and low-fat
red meat, wheat bread, and sweet potatoes, Increase the consumption of water, Keep
taking the drug, Make checks blood sugar regularly every month
(Menghindari stres, banyak mengkonsumsi Kacang polong, kacang panjang, dan
buncis, Daging unggas dan daging merah rendah lemak, Roti gandung, dan ubi jalar,
Memperbanyak konsumsi air putih, tetap mengkonsumsi obat, Lakukan pengecekan
jumlah kadar gula secara rutin setiap bulan)